We are all, at both one and the same time, sufferers and sinners. Sin has both broken our world and tainted our hearts, and as a result we both reap the consequences of living in this broken world and contribute to it in our own personal ways. Maintaining this dual awareness is important as we seek to love and help one another. This is particularly important to keep in mind when seeking to care well for those with mental illness.
As a result of the fall biochemical, physiological, and psychological brokenness exists. Many of us know and love people with real mental illness. We know of people whose brains work differently and whose abilities to process information, respond in situations, and obey instructions are strained. The fallen world falls on us sometimes, and as a result we suffer serious consequences. Most Cognitive-Perceptual disorders, for example, share common features with dementia, and as a result you can expect individuals to have poor executive function, memory, insight, judgment, and self-control. Some individuals can also develop hallucinations and delusions. The ways in which we love and help those who are mentally different, then, must take into consideration their developmental challenges.
Yet, we mustn’t forget the second part of our dual reality: all men are also sinners. Despite suffering the consequences of a real mental-illness all people are also sinners. In the words of Dr. Laura Hendrickson: if people with kidney disorders can still sin, then so can people with brain disorders. Disorder-blindness tempts us to see only suffering, and to see all behavior as a result of the disorder. So, all disobedience, for example, in an autistic child is simply a result of his disorder. But if we are all sinners, and if God holds us responsible for our choices, then we must help those we love learn to identify sin and confront it in their own hearts. This is not always easy, and seeking to discern the difference between physical disability and willful disobedience is very complex, but we must try. For the sake of love and care we must try.
An example may be helpful. Jim was deeply convinced that his entire family was lying to him. He told me that his mother had killed his father and that she had changed his father’s will in order to leave him out of a massive inheritance. Instead, the money had all gone to his mother and siblings who were keeping him in the dark. A simple investigation had proven otherwise, and the police’s investigation of his claims had found similar results – he had actually filed reports. Jim remained unconvinced. He became angry and sometimes could even be aggressive because he was so convinced by the delusion. Jim was Schizophrenic and desperately needed to stay on medication. He had a legitimate suffering that needed regular medical attention. But there were also a number of ways in which he responded sinfully and he needed to be confronted about those responses.
For starters, we addressed how he could respond to his family when he perceived that they were his enemy. The Bible tells us plainly, “love your enemies” (Matt. 5:44). He could not control the delusions he experienced, and they were very convincing in his own mind. But he could control how he responded to his family. Instead of becoming angry and aggressive towards them he could pray for them, as Jesus teaches. We looked carefully at all Jesus said in Matthew 5 about loving enemies. There we read:
39 But I say to you, Do not resist the one who is evil. But if anyone slaps you on the right cheek, turn to him the other also. 40 And if anyone would sue you and take your tunic, let him have your cloak as well. 41 And if anyone forces you to go one mile, go with him two miles.42 Give to the one who begs from you, and do not refuse the one who would borrow from you.
43 “You have heard that it was said, ‘You shall love your neighbor and hate your enemy.’ 44 But I say to you, Love your enemies and pray for those who persecute you, 45 so that you may be sons of your Father who is in heaven. For he makes his sun rise on the evil and on the good, and sends rain on the just and on the unjust. 46 For if you love those who love you, what reward do you have? Do not even the tax collectors do the same? 47 And if you greet only your brothers, what more are you doing than others? Do not even the Gentiles do the same? 48 You therefore must be perfect, as your heavenly Father is perfect.
The goal for him needed to be “love as you have been loved” by God (John 13:34). God had loved Jim while he was an enemy (Rom. 5:10), and so Jim now had an opportunity to love others like Jesus.
Secondly, we needed to stress that it was his pride that kept him from taking his medication. He needed to admit that he had limitations, challenges, and differences that required assistance. He needed to humble himself and accept where God had placed him. This was an even more difficult journey for Jim than the one to love His family. He was eventually able to move in fits and spats towards love. Even moving back in with his mother after nearly a year of being homeless. His pride, however, would keep him very recalcitrant to consistently taking his medication. Admitting that he could not take care of himself, admitting that he had a legitimate mental illness, would not come easy. This is a normal human temptation. Denial and pride are sins for which we can all relate, and Jim was no different. He needed to be challenged on these points. We spoke about his worth and value as a child of God. We spoke about living with faith in the face of his limitations, part of which meant taking his medicine regularly. We talked about what it meant to “humble” ourselves under the “mighty hand of God” (1 Peter 5:6). This is still a struggle for Jim. He remains opposed to admission of his limitations most days, but some days God’s light shines through and he accepts it. I pray his acceptance increases.
Jim has a real mental-illness. He suffers from many things and I am grateful for the care he receives from his psychiatrist. Jim is also a sinner who needs to be encouraged to keep putting sin to death, fighting the good fight of faith, and responding in godliness to his unique challenges. Disorder-blindness would not see Jim as a sinner. It would tempt us to see every behavioral problem simply as a symptom of his brain disorder. Talking with him as both a sufferer and a sinner, however, has allowed us to be both sensitive to his case and encouraging to his growth. Because he is a sinner he can repent of aggression and anger towards his family. He has even been able to move back in with them. That’s not always easy, of course, and his challenges make regular oversight of his interactions at home important. But by God’s grace he has grown and will continue to grow if he keeps repenting.
Jim is like all of us: a sufferer and a sinner. Disorder-blindness will treat him like he is vastly different from the rest of us. Love calls us to recognizes the dual reality of his personhood, the commonality of his temptations, and the possibility of spiritual growth. All instruction and growth will depend upon his development, it will meet him where he is at, but it will help him just the same. Jim can grow, even with a brain disorder.